Bimatoprost
Moderate
Database
No additive efficacy; increased iris pigmentation risk
Do not combine same-class glaucoma drugs.
Drug reference
Latanoprost
Prostaglandin F2-alpha analogue (ophthalmic) · Ophthalmic, Antiglaucoma agent
Also known as Xalatan, Latoprost
START
1 drop 0.005% in affected eye(s) once daily in the evening
TYPICAL MAX
Once daily (no benefit from increased frequency)
STOP IF
Cystoid macular oedema, significant uveitis/keratitis, hypersensitivity
WATCH
IOP response, iris/periocular pigmentation counselling, macular oedema in at-risk eyes, contact-lens removal
CDSCO approvedSchedule HJan AushadhiATC S01EE01
KDIGO 2024 + manufacturer label
- ONSET
- 3.5h · IOP onset
- PEAK
- 10h · peak IOP reduction
- t½
- 17min · plasma acid t½ (~17 min)
- DURATION
- 1d · once-daily effect
EXCRETION
Corneal esterase hydrolysis; minimal systemic, renal
route + CYP
INTERACTIONS
—
none in our sources
PREGNANCY
Use only if clearly needed — limited data; minimal systemic exposure
FDA category + note
Available in India
21 branded formulations and 9 fixed-dose combinations. Look up specific brands in the Drugs workspace.
Jan Aushadhi — generic available at GoI pharmacies
Mechanism
Selective FP prostanoid receptor agonist increasing uveoscleral (and trabecular) aqueous humour outflow, lowering intraocular pressure; topical ophthalmic.
Indications
Open-angle glaucomaOcular hypertension
Dosing
- Adult
- One drop (0.005%) in the affected eye(s) once daily in the evening.
- Pediatric
- Limited efficacy data in paediatric glaucoma; specialist.
- Renal adjustment
- Not applicable (topical, negligible systemic).
- Hepatic adjustment
- Not applicable.
- Geriatric
- No specific adjustment.
- Max dose
- Once daily (more frequent dosing reduces efficacy)
Pharmacokinetics
Onset
IOP reduction ~3–4 h
Peak effect
~8–12 h
Duration
>24 h (once daily)
Half-life
Aqueous/plasma acid ~17 min (negligible systemic)
Bioavailability
Ocular (prodrug hydrolysed by corneal esterases to acid)
Protein binding
Not clinically relevant
Metabolism
Corneal ester hydrolysis; hepatic beta-oxidation of systemic fraction
Excretion
Renal (small systemic fraction)
Contraindications
- Hypersensitivity to latanoprost/benzalkonium
- Caution: active intraocular inflammation, aphakia/pseudophakia with torn posterior capsule, herpetic keratitis history, macular oedema risk
Side effects
Common
Conjunctival hyperaemiaIris pigmentation (permanent brown darkening)Eyelash growth/darkeningPeriocular skin pigmentationPunctate keratitis, eye irritation
Serious
- Cystoid macular oedema (esp. aphakic/pseudophakic with torn capsule)
- Reactivation of herpetic keratitis/uveitis
- Iris pigment change (cosmetically significant, irreversible)
Pregnancy & lactation
Pregnancy
Use only if clearly needed — limited data; minimal systemic exposure
Lactation
Topical, negligible systemic — considered low risk; use with caution
Drug interactions
Other Prostaglandin Analogues
Moderate
Database
Paradoxical IOP increase / reduced effect when combined
Do not combine prostaglandin analogues
Source: Kimi deep-research + Cla
Thiomersal Containing Eye Drops
Moderate
Database
Precipitation if administered together
Separate instillation by ≥5 min
Source: Kimi deep-research + Cla
Contact Lenses
Mild
Database
Benzalkonium absorbed by soft lenses
Remove lenses; reinsert ≥15 min after
Source: Kimi deep-research + Cla
Nsaid
Mild
Database
Topical NSAIDs may blunt IOP-lowering; steroids macular oedema
Monitor IOP; caution in at-risk eyes
Source: Kimi deep-research + Cla
Pilocarpine
Mild
Database
Additive IOP lowering (often intended)
Stagger instillation; monitor IOP
Source: Kimi deep-research + Cla
2 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.
Related guidelines
Ask House about Latanoprost
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19